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Princes <br />Impacted Tenants List (Exhibit A) <br />This List will become Exhibit A of the Grant Agreement that you will enter into with the City of Santa Ana. <br />Households with a Housing Choice Voucher, also known as Section 8, or those who receive other <br />government rental assistance are not eligible. Tenants that you plan to evict are not eligible. It is your <br />decision to include which tenants qualify on this list. Please ensure you have: f) a signed copy of the <br />Lease Agreement verifying occupancy for all tenants on the Impacted Tenants List for whom you are <br />seeking assistance; 2) documentation on file for all tenants an the Impacted Tenants List that <br />demonstrate that the tenant has been impacted by Corona virus and have lost jobs, had their work hours <br />reduced, or have experienced a toss of Income due to the economic or health impacts of Coronavirus and <br />who have been unable to maintain their rent payments under their lease agreements. ,Insufficient or <br />missing documentation may cause a delay in processing or, in some cases, a dental of the application. <br />Additional documentation maybe requested during the review of your application, i hereby attest that the <br />impacted Tenants listed below will be released from any remaining obligation for any rent arrears owed <br />(20%) following payment by the City of Santa Ana (80%). <br />"* The information below may be submitted in a separate spreadsheet attached to your application <br />Please Include the minimum information below and name it Exhibit A — Property Name, ** <br />Property Name: The Marke at South Coast Metro, LLC <br />Property Address: 100 E. MacArthur Blvd. Santa Ana, 92707 <br />Tax ID for Payment: 45.5444055 <br />Full Name of Tenant <br />(as stated on the Lease) <br />Address of Tenant's Rental Unit <br />Total Amount <br />of Rent Arrears <br />Owed <br />Jesus Ortega <br />100 E. MacArthur Blvd #337 <br />$ 18,838 <br />Goerge Myrlck <br />100 E, MacArthur Blvd. #434 <br />$ 16,830 <br />Ahmed Rebel, Rabial Dhlasddlne <br />100 E.MaCArthur Blvd. #465 <br />$ 12,565 <br />Augustus, David Augustus, Brenda Simon <br />100 E, MacArthur Blvd. 368 <br />$ 6,738 <br />Kahroba A azl Jose Gutierrez <br />100 E, MacArthur Blvd. #363 <br />$ 6,090 <br />Don Nguyen <br />100 E. MacArthur Blvd #126 <br />$ 4,543 <br />Juan Garcia <br />E MgcArthur Blvd #309 <br />$ 10,768 <br />$ <br />Total Amount of Assistance <br />Requested <br />$ 7,i72.00 <br />*Add additional pages if necessary. If you have multiple properties and you are unable to <br />accept payment on behalf of all of them, please list each property separately and provide the <br />name of the property at the top of each fist. <br />Coronavirus Emergency Rental Relief Fund for Landlords Page 13 <br />Application <br />